| NPI | 1568400844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC002437L) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000464L) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-10-12 |